1. dr. Novita Damayanti, Sp.KK

2. Your Changing Body When we talk about these changes it is normal to feel… curious disgust comfortable excitedembarrassed shy

3. WHAT IS PUBERTY  Is the process of developing/transforming into an adult, which is including maturation of the physical body outside and emotionally mental inside.

5. When does it occur ?  It varies among individuals  Genetic, nutritional and environmental may influence the average age of the puberty  Hypothalamus and Pituitary glands start making some hormones like Growth Hormone, LH (Luteinizing Hormone) and FSH (Follicle Stimulating Hormone) that act on parts of your body  The pituitary also make sex hormones like Testosterone (most in boys) and Estrogen (most in girls)

6. BOYS  Somewhere between 10 and 15 years  With quite a lot of boys the first changes start to happen around 11 or 12 years old GIRLS  Anywhere between 8 and 13 years (sometimes earlier/later)  Often first changes happen around 10 or 11 years old

8. At 8-12 At 8-14 At 9-15 At 10-16 At 12-19 At 9-12 At 12-13 At 13-14 At 14-15 At 15-18

10. What changes happen to boys? Grow taller and heavier Bones grow bigger and heavier Nose and jaw get bigger and face gets longer Prominent adam’s apple Get more muscles Hair and skin can become oily and you may get pimples Body sweats more

11. What changes happen to boys? Hair grows on the face, under the arm, around the genitals (pubic hair), may get more hair on arms, legs and chest. Voice gets deeper Penis and testicles grow Scrotum changes May have mood swings, sexual thoughts and feelings Breasts may grow

12. What causes these changes?

13. What will I look like when I grow up? That depends mostly on your HEREDITY, the GENES you got when an egg cell and a sperm cell from your birth parents came together to make the cells that developed into you Genes mostly determine how tall you will grow, the colour of your hair, the size and shape of your penis or breasts and your overall body shape. Other things that affect our body are the foods we eat, how active we are and how much sleep we get.

14. What are the sex organs? These parts are also called the reproductive organs and genitals Urethra Penis Testicles or Testes Scrotum The parts are:

15. What are the sex organs? Urethra -the tube through which urine and semen leaves the boy’s body Penis -tube-like organ that hangs outside the body -come in all sizes and shapes, determined by our genes Testicles or testes -usually two, one hangs lower -Sometimes called balls or nuts -Where sperm are made Scrotum -bag of skin that holds testicles -keeps them at right temperature to make sperm, slightly cooler than body’s temperature -gets bigger and baggier and turns a darker colour

16. What happens on the inside? Hormones from the pituitary make the testicles grow and they start making more testosterone and producing sperm After puberty you make 200,000 - 400,000 sperm cells a day for the rest of your life Sperm build up in tubes around the testicles – They travel along some tubes and mix with fluids from glands

17. What happens on the inside? Sperm + fluids = semen

18. How does the semen come out? If semen is going to come out, the penis is likely to be erect A penis gets erect when blood rushes into it Muscles push the semen into the urethra and out the penis This is called an ejaculation.

19. What can cause an erection? Boys get erections for all kinds of reasons – they might happen if you : – Are thinking about something sexy – When you wake in the morning and have to pee – When you are relaxed – When you are anxious or frightened – For no reason at all

20. When does ejaculation happen? If a boy wakes up and finds a wet, sticky spot on his bedclothes semen came out when he was sleeping. This is called a “wet dream” If a boy touches or rubs his penis and it gets erect and semen comes out. This is called masturbation. Some boys have wet dreams, some don’t Some boys masturbate, some don’t However it happens is okay

21. Does penis size matter? Testicles grow first so your penis may look as if it is shrinking. It can take a while for your penis to grow. Penises, like noses and ears and hands, come in all sizes and shapes and colours. They vary how they curve and stick out when erect. Penises, when erect, are more alike in size than when they are soft.

22. What is circumcision ?

23. What is the benefit of circumcision ? A decreased risk of urinary tract infections. A reduced risk of some sexually transmitted diseases in men. Protection against penile cancer cancer Prevention of balanitis (inflammation of the glans) and balanoposthitis (inflammation of the glans and foreskin). Prevention of phimosis (inability to retract the foreskin) and paraphimosis (inability to return the foreskin to original location)phimosis (the inability to retract the foreskin)

25. Bodies curvier, hip bones widen Weight gain, muscle more bigger and stronger Decrease stature Increse secretion of oil and sweat gland may cause acne Growth of body hair (underarms, pubic hair) Menstruation starts. You may get some jelly from vagina before or in between periods What changes happen to girls?

26. Girls may have breasts, are two mounds of flesh, grow on the chest of girls on puberty Inside the breasts are glands, able to make milk (if woman has a baby) and contain of fat BOYS have breasts but it flattens when they reach the end of puberty

27. 2 Age Range: Usually 8-14. Average: 11-12 The first sign is typically the beginning of breast growth, including "breast buds." A girl may also grow considerably in height and weight. The first signs of pubic hair start out fine and straight, rather than curly.curly Stages of Breasts Growth First stagesecond stage Third stage Fourth stage Fifth stage

28. Why girls are wearing Bra ? Wearing bra - Bras protect and support breasts - you fell more comfortable, good giving a shape Buying bra - sports bras are comfortable at first, but sometimes girls need under-wire bras

29. knowing your bra size, it is good idea to be measured by the sales woman/ between you and mom - measure round your body under your breast - measure round again (fuller part of your breast/ bust size) - try it on and make sure its comfortable

30. Comes from Latin word “MENS” means month, also call menses, period, catamenia Menstruation is part of the female reproductive process Average 28-day cycle, but different for everyone Your period is when you lose fluid at the end of the cycle What is Menstruation ?

31. Female Reproductive System

32. Menstrual cycle

33. When Does My Period Start? Usually between 10-16 years old About 2 years after your breasts develop Soon after you grow pubic hair After you start to notice vaginal discharge Usually last 3-7 days Might not be regular at first Only lose about 7 teaspoons of blood It doesn ’ t hurt!

34. What may happen when you have periods ? Girls who don’t have much fat or lose a lot of weight may not have regular periods Worrying or stress Girls who smoke have more painful periods Many girls get cramping their tummy in the beginning of periods Firstly dark reddish brown blood then becomes redder

35. What Are They? Aches in the lower abdomen or along the inner thighs What Can I Do? Take a warm bath Hold a heating pad on your lower stomach Exercise Check with an adult before taking medication Cramps on your periods

36. Pantiliners Pads Tampons Using Feminine Protection

37. Pantiliners Worn outside your body, in your underwear Use: – When period is light – As tampon backup – In between periods to absorb discharge and help keep you fresh every day

38. Pads Worn outside your body, in your underwear Many different kinds, depending on heaviness of period and body size Wings provide extra protection Change frequently to keep fresh and dry

39. How to Use a Pad 1. Pull off paper strip or wrapper. 2. Attach sticky part securely to center of underwear. 3. For wings, peel off paper strips and wrap around sides of underwear.

40. How to Get Rid of Pads Fold it up Wrap it in tissue or toilet paper Put it in the trash (special cans in ladies ’ room) Don ’ t flush pads down the toilet – they clog it! Wash your hands

41. Tampons Worn inside your body in your vagina to absorb menstrual flow Range of absorbencies Good for swimming and gymnastics Toxic Shock Syndrome Safety information inside box

42. Sweating Body produces more sweat; body odour Bathe/shower daily with soap Shampoo hair regularly, from root to tip Control underarm odor and wetness with deodorant or antiperspirant Change sweaty clothes Personal Hygiene BOYS and GIRLS

43. Skin Care Oil glands in your skin become more active Oil and dead skin cells lead to acne Cleanse skin twice a day Don ’ t worry; acne is a normal part of puberty, and steps can be taken to reduce it

44. Stay active – exercise! Eat nutritious foods Regular bathing and dental care Personal safety Healthy Bodies

45. Emotional Changes Starting to feel more attracted to other people Having mood swing Feeling things more intensively experiencing more anxiety feeling more withdrawn from your parents caring more about your appearance

46. Surviving Puberty Some tips for surviving puberty : Ask lots of questions, learn more about the subject Accept your body and trust your self Remember that a friend is biggest present you can give your self Try telling to people instead of keepig quiet Smile to the world and it will smile back !!!

47. Family member: Your mom, dad, aunt, grandma, etc. - Mother/daughter booklet Teacher or school nurse Doctor Trusted adult Who to Talk To

48. Is there Early or Late Puberty ? Precocious puberty - is the term for early puberty - usually due to hormonal changes, ex.breast or pubic hair develop at 6-7 yo Delayed puberty - the late onset of puberty - ex testicular vol not increase at 14 yo